经颅多普勒超声动态监测应用于蛛网膜下腔出血患者发生脑血管痉挛中的价值  

The value of transcranial Doppler ultrasound dynamic monitoring applied to the occurrence of cerebral vasospasm in patients with subarachnoid haemorrhage

作　　者：何丽[1] 宿艳[1] 戴志成[2] 寇明倩 HE Li;SU Yan;DAI Zhicheng;KOU Mingqian(Department of Electrophysiology,The First People's Hospital of Baiyin City,Baiyin,Gansu,730900,China;Department of Neurosurgery,The First People's Hospital of Baiyin City,Baiyin,Gansu,730900,China)

机构地区：[1]白银市第一人民医院电生理科,甘肃白银730900 [2]白银市第一人民医院神经外科,甘肃白银730900

出　　处：《当代医学》2024年第7期47-50,共4页Contemporary Medicine

摘　　要：目的探讨经颅多普勒超声动态监测应用于蛛网膜下腔出血(SAH)患者发生脑血管痉挛中的价值。方法选取2018年6月至2021年6月白银市第一人民医院收治的85例SAH患者作为观察组,另选取同期76名健康志愿者作为常规组。比较两组收缩期峰值流速(Peak)、搏动指数(PI)及平均血流速度(Mean),比较观察组发生与未发生脑血管痉挛患者的PI、Peak及Mean,分析PI、Peak、Mean单独及三者联合对SAH患者发生脑血管痉挛的诊断价值。结果观察组PI高于常规组,Peak、Mean慢于常规组,差异有统计学意义(P<0.05)。观察组发生脑血管痉挛10例,未发生脑血管痉挛75例,发生脑血管痉挛患者PI高于未发生脑血管痉挛患者,发生脑血管痉挛患者Peak、Mean慢于未发生脑血管痉挛患者,差异有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,PI、Peak、Mean是脑血管痉挛发生的危险因素(P<0.05)。PI、Peak、Mean联合诊断脑血管痉挛的灵敏度高于单独诊断(P<0.05)。结论经颅多普勒超声动态监测在SAH患者发生脑血管痉挛中的应用价值较高,PI、Peak、Mean是脑血管痉挛发生的危险因素,三者联合对脑血管痉挛的诊断灵敏度较高。Objective To investigate the value of transcranial Doppler ultrasound dynamic monitoring applied in the occurrence of cerebral vaso-spasm in patients with subarachnoid haemorrhage(SAH).Methods 85 cases of SAH patients admitted to the First People's Hospital of Baiyin City from June 2018 to June 2021 were selected as the observation group,and another 76 cases of healthy volunteers in the same period were selected as the routine group.Peak systolic flow velocity(Peak),pulsatility index(PI)and mean blood flow velocity(Mean)were compared between the two groups,and PI,Peak and Mean were compared between patients with and without cerebral vasospasm in the observation group,so as to analyse the diagnostic value of PI,Peak,and Mean alone and the combination of all three on the occurrence of cerebral vasospasm in SAH patients.Results The PI in the ob-servation group was higher than that in the routine group,and Peak and Mean were slower than those in the routine group,and the difference was statis-tically significant(P<0.05).There were 10 cases with cerebral vasospasm and 75 cases without cerebral vasospasm in the observation group;the PI of patients with cerebral vasospasm was higher than that in patients without cerebral vasospasm(P<0.05),and Peak and Mean of patients with cerebral vasospasm were slower than that of patients without cerebral vasospasm,and the difference was statistically significant(P<0.05).The results of multi-factorial Logistic regression analysis showed that PI,Peak and Mean were risk factors for the occurrence of cerebral vasospasm(P<0.05).The sensitiv-ity of the combined diagnosis of cerebral vasospasm with PI,Peak and Mean was higher than that of the diagnosis alone(P<0.05).Conclusion Tran-scranial Doppler ultrasound dynamic monitoring has high value in the occurrence of cerebral vasospasm in patients with SAH,and PI,Peak,and Mean are risk factors for the occurrence of cerebral vasospasm,and the combination of all three has high diagnostic sensitivity for cerebral vasospasm.

关 键 词：搏动指数 经颅多普勒超声 蛛网膜下腔出血 脑血管痉挛 

分 类 号：R743.35[医药卫生—神经病学与精神病学]